Page 15 - Journal of Laparoscopic Surgery - WALS Journal

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10.5005/jp-journals-10033-1262
Laparoscopy in Gynecology
ORIGINAL ARTICLE

Laparoscopy in Gynecology: Experience

from a Rural Hospital

3
2
1 Nidhi Bhutani, Harpreet Kaur, Sushmita Sharma
ABSTRACT INTRODUCTION
Introduction: Laparoscopy as a modality for the diagnosis Laparoscopy as a modality for the diagnosis of pelvic
of pelvic pathology has been well-established in recent pathologies has been well-established in recent times.
times. Besides aiding in diagnosis, it is an important tool for
management in the same sitting preventing unnecessary Besides aiding in diagnosis, it is an important tool for
laparotomy in many cases. management in the same sitting preventing unnecessary
laparotomy in many cases. It has a role both in elective
Aim: The aim of the article was to know the common indica- cases and in patients diagnosed with acute abdominal
tions of performing diagnostic laparoscopy, intraoperative
findings, and various interventions done during surgery. It gynecologic emergencies who are hemodynamically
was also aimed to highlight the importance of laparoscopy as stable and can be effectively managed with minimally
a minimum basic requirement for diagnosing many common invasive technique.
pelvic pathologies. Infertility is one of the common indications for diagnos-
Materials and methods: Indications for laparoscopy, intraop- tic laparoscopy where it has been suggested as a mandatory
erative findings, and interventions done during surgery were step to preclude the existence of peritubal adhesions and
1
studied in 75 patients who underwent laparoscopy between endometriosis as its cause. Also it is an important tool to
January 2012 and December 2014 at Gian Sagar Medical make a diagnosis of unexplained infertility.
College and Hospital. Besides infertility, the other common indication for
Results: Maximum number of patients (75; 76%) were in the diagnostic laparoscopy is chronic pelvic pain (CPP). An
age group of 21 to 30 years. The main indication for laparoscopy estimated 4 to 20% of women between the age of 15 and
was infertility in 58 cases (77.33%) followed by chronic pelvic 45 years suffer from CPP. According to Gelbaya and
2,3
pain in 4 cases (5.3%). Tubal factor was the commonest cause 4
of infertility seen in 19 (32.75%) cases. In majority of patients El-Halwagy, CPP is the cause for approximately 40% of
with previous history of tuberculosis, adhesions were found laparoscopies. To assess the presence of endometriotic
to be the cause of chronic pain and infertility. Ovarian drilling lesions in CPP, laparoscopy is the gold standard. 5
was the most common intervention done in 12 cases and Our study was aimed to know the common indications
adhesiolysis in another 11 cases. of performing diagnostic laparoscopy, intraoperative
Conclusion: Laparoscopy is an essential intervention in findings, and various interventions done during the
detecting many pelvic pathologies which are difficult to dia- surgery. Another aim was to highlight the importance
gnose on clinical examination. Its diagnostic and therapeutic of laparoscopy as a minimum basic requirement for
potential has made it a safe, feasible, and less invasive diagnosing many common pelvic pathologies.
modality for evaluation of infertility, chronic pelvic pain, and
endometriosis.
MATERIALS AND METHODS
Keywords: Chronic pelvic pain, Infertility, Laparoscopy.
This cross-sectional study was carried out in the Depart-
How to cite this article: Bhutani N, Kaur H, Sharma S. ment of Obstetrics and Gynecology from January 2012
Laparoscopy in Gynecology: Experience from a Rural Hospital. to December 2014 at Gian Sagar Medical College and
World J Lap Surg 2016;9(1):13-16.
Hospital, which mainly caters to the rural population.
Source of support: Nil All patients who underwent elective/emergency
Conflict of interest: None diagnostic laparoscopy irrespective of the indication were
included in the study. Patients for elective laparoscopic
hysterectomy, hemodynamically unstable patients, and
2,3
1 Assistant Professor, Associate Professor those unfit for procedure because of any medical or sur-
1-3 Department of Obstetrics and Gynecology, Gian Sagar gical condition were excluded from the study. A total of
Medical College and Hospital, Patiala, Punjab, India 75 patients underwent diagnostic laparoscopy during
the study period.
Corresponding Author: Harpreet Kaur, #26-B, Central Govt.
Officer’s Residence, Sector 38-A Chandigarh-160036, India After a detailed history and thorough general phy-
Phone: +919872221818, e-mail: drharpreet_sidhu@hotmail. sical examination including per speculum and per
com
vaginal examination and preanesthetic checkup, a
World Journal of Laparoscopic Surgery, January-April 2016;9(1):13-16 13